Surgeons Scope Magazine - July 2022

Keeping Burnout at Bay

IT’S BEEN PROVEN THAT HOBBIES CAN HELP SURGEONS COPE WITH STRESS AND BUILD PHYSICAL AND MENTAL RESILIENCE. WE TALK TO SURGEONS FOR WHOM A HOBBY IS A LIFELINE

After what has been an undeniably tough couple of years for everyone, but particularly for those on the frontline, the topics of stress and wellness as they relate to healthcare professionals have never been more topical.

Last year, the Irish Journal of Medical Science reported on an IMO survey of doctor wellbeing in Ireland revealing 70% of doctors are at risk of burnout. Mindfulness and yoga are often recommended as useful antidotes.

Ms Shirley Potter, Consultant Plastic and Reconstructive Surgeon, MMUH, Associate Clinical Professor at UCD, switches off with long distance endurance running. She’s participated in ultramarathons ranging in length between 50-250km and also competes in road cycling and open water swimming events. Some of the events in which she’s taken part are the 250km Sahara Desert Race, the Zurich Ironman (3.9km swim, 180km cycle, 42.2km run), the 100km Blue Mountains Race in NSW, Australia, and the 250 km Gobi Desert Race.

EXTREME ENDURANCE

Ms Shirley Potter FRCSI (2015)

“In my view,” says Ms Potter, “it is essential for a surgeon to have hobbies. Endurance running has allowed me to build both physical and mental stamina, and resilience, which are important abilities I transfer to my work life as a surgeon. My hobbies give me an enormous sense of achievement, not just the training beforehand but the challenge to complete long distance endurance events, going through tough physical and psychological conditions.

“It allows me to have time to myself and to put everyday stress into perspective.”

Shirley Potter

“The ability to keep going in spite of extreme physical and mental fatigue, in order to achieve a final goal, has helped me to combat burnout. Running for me is the ultimate escape from stress, it allows me to unwind and clear my head. I’ve never not felt good after exercise. I have met great friends through these activities and have visited amazing, often untouched, places around the world.”

Burnout is defined as a psychological condition that emerges from prolonged response to chronic stressors in the workplace. It is characterised by overwhelming exhaustion and depersonalisation, and often results in reduced productivity or capability, low morale and inability to cope.

Recognising that burnout is a real and tangible risk, one that could have devastating consequences for patients, impact negatively on relationships with colleagues, and also have serious career-limiting consequences is something of which all surgeons need to be aware. And rather than dismissing burnout as something that happens to others, each surgeon needs to evaluate and acknowledge their personal susceptibility and triggers, and develop an individual strategy to keep it at bay.

Of course it’s not only surgeons who are at risk of burnout. People at every level of seniority in every field are susceptible, but when burnout affects those who are expected to perform at the very highest level day in, day out, those whose decisions and actions impact upon the lives of others, it can’t be ignored.

Research backs up Ms Potter’s conviction that hobbies can help. Writing in Forbes, Bob Bennett of EngageSmart, references a study in the Annals of Behavioural Medicine confirming that hobbies can help reduce or prevent burnout by giving us a chance to take a break from everything else in our lives.

“Having a [hobby] can actually add years to your brain’s life,” says Bennett, citing another study from Aging showing the best way to improve brain plasticity is to “practice new tasks intensively”. So getting to grips with a new language or learning a new stitch in knitting is proven to keep your brain sharper for longer.

Rates of depression also tend to be lower in those who have hobbies. “This may be because they allow us to feel a sense of accomplishment,” writes Bennett. I know that when I was first able to coax a few bars of The White Stripes’ ‘Seven Nation Army’ out of my guitar, I felt a sense of pride that differed from the pride I feel at work.”

Golf, tennis and cycling are three of the most popular de-stressors, but others find slower-paced pursuits such as cooking and baking, gardening, playing a musical instrument and singing in a choir work best for them. For a hobby to be an antidote to burnout, it needs to help you disconnect from work, be enjoyable and help you feel good. It helps if it also involves mastery and gives you a sense of achievement and control.

Winston Churchill painted in his spare time, and many believe his hobby made him a more effective leader, thanks to the improved powers of observation and memory the hobby brought him. Churchill himself drew parallels between the role of a general in battle and a painter.

Around the world, surgeons have hobbies as diverse as one might expect from a cohort of high-achieving mavericks. There are surgeons who practise aerial silks – a Cirque du Soleil type of acrobatics – and others who keep bees.

Surgeon Harold E Chung-Loy, practising in New Jersey, owns a farm in his native Jamaica where he grows Blue Mountain coffee beans and has set up a roastery near home back in the US.

Max Emory Lake, an Australian surgeon, Australia’s first specialist hand surgeon, who died in 2009, was regarded as the founder of the Australian boutique wine industry, running his Lakes Folly winery in the Hunter Valley on his weekends off. He also wrote books on wine, food and surgery and inspired a cohort of surgeons in Australia to get involved in vineyards.

While the Irish climate may not lend itself so well to wine-making, there is rarely a television cooking competition that doesn’t feature a medic as a competitive baker or cook. The precision involved in producing intricate dishes and complex bakes chimes well with the surgeon’s skill set.

While Ms Potter’s hobby is all about endurance and stamina, hobbies don’t have to be as physically challenging as hers to be beneficial. Research shows that the key thing is that the hobby absorbs you and requires your full attention.

Rocking It

Professor Ciaran Bolger

Professor Ciaran Bolger, Consultant Neurologist at Beaumont Hospital, holds a private pilot’s licence, flies regularly and says that outside of medicine his major interest is flying. When he was President of Eurospine, he put his twin-engine Beech Baron to good use, flying it around Europe at 25,000 feet between meetings.

FLYING HIGH

Professor Ciaran Bolger FRCSI (1991)

“By doing something totally different to my work, but that also involves challenge, I get a break from routine and the everyday stress of work,” he explains. “It’s important to have a diversion, to operate in a different space – an escape.”

Professor Bolger revealed in a recent interview with Irish comedian and TV show host Tommy Tiernan that he also fronts a rock band and has an XBox on which he plays games. He reckons this is good for hand-eye coordination and mental stimulation.

“Getting out in the wonderful Irish landscape never fails to re-energise me after a busy week at work.”

Paul O'Brien

Mr Paul O’Brien, consultant ophthalmic surgeon, Blackrock Clinic, believes it’s important to have several hobbies outside of work.

“I like to have some that involve physical activity such as cycling or walking, some sporting such as golf and others that can also be continued into latter years of life.”

LANDSCAPE PHOTOGRAPHY ‘Poolbeg Full Moon’

Mr Paul O’Brien FRCSI (2000)

O’Brien’s hobby of landscape photography falls into this latter category and he believes it makes him less susceptible to fatigue.

“Getting out in the wonderful Irish landscape never fails to re-energise me after a busy week at work,” he says. “Even if photographic conditions prove less dramatic than expected, the fresh air and experiencing sunrise sets me up well for the day and week ahead. There is a certain satisfaction in catching epic light and the perfect shot. I hear sea swimmers extolling similar virtues of a sunrise swim.”

Upper Boat Lake

Mr Paul O'Brien

And while photography may appear to be a solitary hobby, Mr O’Brien says it doesn’t have to be that way.

“I regularly chat with other photographers whenever I go out early for sunrise. It also helps to grab an early coffee on the way back home. Devotion to work is important but it is even more important to have interests outside of work. After all, when retirement beckons around 65, it’s really important to have something to spur you on to get up every morning with a purpose and the prospect of some social interaction to boot.

“I am always trying to land the epic photo. This rarely happens and so a future trip always beckons, a bit like the fisherman waiting for that one big catch. Unlike golf, I never return home after a sunrise photo outing feeling battered and dejected. I forget about the stresses of work whilst out walking to a landscape location and searching for a unique photographic composition. There is the challenge of producing something different as well as technically proficient.”

“It’s a break, it doesn’t care about daily worries and doesn’t care how important you might think you are. Especially when racing, your professional reputation doesn’t matter – the other drivers will likely be better and much younger!!”

Professor John RT Monson, Colorectal Surgeon

Colorectal surgeon, Professor John RT Monson MD FRCSI, Chair, Digestive Health and Surgery Institute, AdventHealth Central Florida, has had a lifelong interest in motorsports. As a young man he raced motorbikes, latterly it’s been vintage cars. He also collects classic road cars and races other cars when possible.

“I am certain hobbies matter,” says Professor Monson. “Some surgeons say ‘my work is my hobby’ but I personally believe that is a slight cop-out. There is a life after surgery and we also don’t know when that might be. I have raced in countries around the world and met many fascinating and wonderful friends.

RACING DEMONN

Professor John RT Monson FRCSI (1983)

Having hobbies makes for a more rounded approach to life. It’s a total break from work because driving at 175mph doesn’t permit any focus on work! Several times over the years, colleagues have told me I need to go and race cars for a weekend because I was grumpy!”

“Surgeons are thought to be primadonnas, but they are way easier to organise than a group of musicians.”

Professor Austin Leahy

If the adrenalin rush of racing does not appeal, there’s a different kind of rush to be gained from performing in a blues band, the hobby of Professor Austin Leahy, retired consultant vascular surgeon at the Beacon and Bon Secours hospitals. He says that rock and roll, in all its forms – from avid fan to lead singer with the Transformation Blues Band, to releasing music and performing under his own name – was a lifeline during a stressful career.

ROCK STAR

Professor Austin Leahy FRCSI (1981)

“Having some creative outlet certainly served as an energiser and stress buster, even if it was sometimes physically exhausting and emotionally demanding,” he says. “Writing, composing poetry or painting are the acceptable outlets of professionals. Writing, performing or recording rock music proved difficult for some of my colleagues to accept, but it is an excellent way to express emotions and vent. Music is creative, expressive, and rewarding. Surgeons are thought to be primadonnas, but they are way easier to organise than a group of musicians. Was all the effort worth it? Was it more exhausting for me or the listener? You can decide by listening to ‘Austin Leahy’ on Spotify.” ■

SURGEONS SCOPE / 15